APPENDIX I
(See Paragraph-6)
FORM 1M
Note : If space provided against any parameter is inadequate,Kindly upload supporting document under 'Additional Attachments if any'  at the last part of the Form 1M. Please note that all such Annexures must be part of single pdf document.
(I)Basic Informations
S.No.Item Details
(i).Name of the Mining Lease site Granite Building Stone Quarry of Shri. Shafir.P
(ii).Location / site (GPS Co-ordinate) N11°59'46.574" to N11°59'51.065" and E75°35'25.861" to E75°35'31.023"
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)1.1030 ha.
(iv).Capacity of the Mining Lease (TPA) 50080
(v).Period of Mining Lease 6
(vi).Expected cost of the Project 80
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?Yes
Accreditation No.73 
Name of Consultant/RQPGlobal Environment & Mining Services
Address 394, HBR Layout, 1st stage, 1st cross, 5th main, 5th block
Mobile No.9880788836
Landline No.25432447
Email Idgems.blr@globalmining.in
(II) Environmental Sensitivity
S.No Areas Distance in kilometer / Details
1. (i).  Nearest rail or road bridge over the concerned river,rivulet,nallah etc. in kms.  5.5 km
2. (ii). Nearest Infrastructural along with distance in kms  27.5 km
(iii). Nearest Railway Line along with distance in kms  27.5 km
(iv). Nearest National Highway along with distance in kms  33 km
(v). Nearest State Highway along with distance in kms  1.70 km
(vi). Nearest Major District Road along with distance in kms 7 km
(vii). Nearest Any Other Road along with distance in kms  0.425 km
(viii). Nearest Electric transmission line pole or tower distance in kms  6 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  6 km
(x). Nearest In-take for drinking water pump house distance in kms  5.8 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  6 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
 None within 5 Kms of the project site
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests Forest: Kunnathur VF, 9.30Kms Pond: Kalliad, 1.50 Km River: Tirur, 5 Kms Coast :Kannur Coast - 48 Kms
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration None within 5 Km of the project site
6. Inland, coastal, marine or underground waters Kannur Coast - 48 Kms
7. State, National boundaries Karnataka State boundary is 16.0 Kms from the project site.
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas National Highway: Edapally-Panvel Highway (NH-17), 33 Km . State high way: Malabar Hill Highway(SH-59), 1.70 Kms. Major District Road: Irikkur-Thaliparamba Rd, 7.0 Kms
9. Defence installations None within 5 Km of the project site
10. Densely populated or built-up area, distance from nearest human habitation There is no human settlement in core zone. The nearest habitants are more than 100m away from the boundary of the mining lease area. The nearest human settlements are in Kalliad Village, which is about 1.20 Kms from the mining lease area.
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Hospital : Govt. Hospital, Irikkur, 9.0 Kms. School : English Valley Public School, 4.60 Kms. Church : Believers Church, Padiyoor, 7.0Kms. Temple : Kuyiloor Kavu Temple, 1.60 Kms. Mosque/Masjid : Kuyiloor Masjid, 1.30 Kms. Anganwadi: Kuyiloor, 2.0 Kms.
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) None within 5 Km of the project site
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) Not applicable, since this is Fresh proposal
14. Areas susceptible to natural hazard which could cause the project to present environmental problems (earthquakes, subsidence, landslides, erosion, flooding or extreme or adverse climatic conditions) No, Lease area is not susceptible to natural hazard, as there is no history of such incidents.
15.
Is proposed mining site located over or near fissure/fracture for ground water recharge?No
16.
Whether the proposal involves approval or clearance under the following Regulations or Acts namely?
(a).
The Forest (Conservation) Act,1980?No
(b).
The Wildlife (Protection) Act,1972?No
(c).
The Coastal Regulation Zone (C.R.Z) notification,2011?No
17.
Is forest land involved (ha)?No
18.
Whether there is any litigation pending against the project and/or land in which the project is proposed to be set up?No
19.
New/Expansion/ModernizationNew
Proposal NumberDIA/KL/MIN/14604/2018
File Number158/ECA/KNR/2018/DEIAA
Date of Apply EC17 Apr 2018
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KeralaKannurTaliparamba
(III) EC Attachments
1 Uploaded PFR (Pre Feasibility Report) File Annexure-PFR file
2 Uploaded Approved Mining Plan File Annexure-Approved Mining Plan file
3 Uploaded District survey report Annexure-District Survey Report
4 Uploaded Cover Letter Annexure-Cover Letter
Uploaded Additional attachments, if any
S.No. Attached File Date of Submission
(1.)500m Radius Certificate17 Apr 2018
(2.)Affidavit for EC17 Apr 2018
(3.)Declaration of Individual17 Apr 2018
(4.)Form 1M17 Apr 2018
(5.)NABET Certificate17 Apr 2018
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameSHRI SHAFIR P
DesignationOwner
Company SHRI SHAFIR P
AddressMPK Manzil, Therur P.O,
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